@layout("/common/_container.html"){
<div class="ibox float-e-margins">
	<div class="ibox-content">
		<div class="form-horizontal">

			<input type="hidden" id="id" value="">

			<div class="row">
				<div class="col-sm-4 b-r">
							<#input id="name" name="名字" underline="true"/> 
							<#select id="sex" name="性别" underline="true">
								<option value="1">男</option>
								<option value="2">女</option>
							</#select>
                            <#input id="age" name="年龄" underline="true"/>
                            <#input id="school" name="学校" underline="true"/>
                </div>

				<div class="col-sm-4">
				<#input id="phone" name="电话号码" underline="true"  autocomplete="off"/>
	            <#select id="type" name="费用类型" underline="true" >
                    <option value="1">报名费用</option>
					<option value="2">装备费用</option>
					<option value="3">报名及装备费用</option>
				</#select>
				<#input id="money" name="费用（元）" underline="true"/> 
				 <#select id="fromTo" name="来源" underline="true" >
                    <option value="1">个人</option>
					<option value="2">学校</option>
				</#select>
			</div>
			
			<div class="col-sm-4 b-r">
				<#input id="registTime" name="进账日期" underline="true" clickFun="laydate({istime:false,format:'YYYY-MM-DD'})"/>
					 <#select id="level" name="等级" underline="true">
									<option value="1">课时数</option>
									<option value="2">月卡</option>
									<option value="3">年卡</option>
					 </#select>
					 <#input id="classNumber" name="课时" underline="true"/>
					 <#input id="remark" name="备注" underline="true"/></div>
                </div>

			<div class="row btn-group-m-t">
				<div class="col-sm-10"><#button btnCss="info" name="提交"
					id="ensure" icon="fa-check" clickFun="IncomeInfoDlg.addSubmit()"/>
					<#button btnCss="danger" name="取消" id="cancel" icon="fa-eraser"
					clickFun="IncomeInfoDlg.close()"/></div>
			</div>
		</div>

	</div>
</div>
<script src="${ctxPath}/static/modular/income/income/income_info.js"></script>
@}
